Individual
AILIS ROOSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
17500 W GRAND PKWY S, SUGAR LAND, TX 77479-2562
(832) 655-4141
Mailing address
445 WARDS HILL RD, WARWICK, MD 21912-1248
(443) 945-6194
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
17257
TX
Other
Enumeration date
11/10/2023
Last updated
11/10/2023
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